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Medical Mutual of Ohio Radiology CPT Code List

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Medical Mutual of Ohio Radiology CPT Code List Medical Mutual of Ohio Radiology CPT Code List Category CPT® Code CPT® Code Description 3D Imaging 76376 3D Rendering W/O Postprocessing 3D Imaging 76377 3D Rendering W Postprocessing BMRI 77046 Magnetic resonance imaging, breast, without contrast material; unilateral BMRI 77047 Magnetic resonance imaging, breast, without contrast material; bilateral Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time BMRI 77048 lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (CAD real-time BMRI 77049 lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral Cardiac: CT 75571 Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image Cardiac: CT 75572 postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed) Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of Cardiac: CT 75573 congenital heart disease (including 3d image postprocessing, assessment of lv cardiac function, rv structure and function and evaluation of venous structures, if performed) Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, Cardiac: CT 75574 including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed) Cardiac: MR 75557 Cardiac magnetic resonance imaging for morphology and function without contrast material Cardiac: MR 75559 Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) Cardiac: MR 75561 and further sequences Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) Cardiac: MR 75563 and further sequences; with stress imaging Cardiac: MR 75565 Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure) Updated: 2/7/2019 V1.2019 Effective: 1/1/2019 Category CPT® Code CPT® Code Description Cardiac: Myocardial 78451 myocardial perfusion imaging, tomographic (spect) including attenuation correction, qualitative or quantitative wall Perfusion Imaging 78451 motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or (Nuclear Stress) stress (exercise or pharmacologic) Cardiac: Myocardial Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, Perfusion Imaging 78452 ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or (Nuclear Stress) stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection Cardiac: Myocardial Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated Perfusion Imaging 78453 technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic) (Nuclear Stress) Cardiac: Myocardial Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated Perfusion Imaging 78454 technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) (Nuclear Stress) and/or redistribution and/or rest reinjection Cardiac: Myocardial Myocardial strain imaging (quantitative assessment of myocardial mechanics using imagebased analysis of local myocardial Perfusion Imaging 0399T dynamics) (List separately in addition to code for primary procedure) (Nuclear Stress) Cardiac: PET 78459 Myocardial imaging, positron emission tomography (pet), metabolic evaluation Cardiac: PET 78491 Myocardial imaging, positron emission tomography (pet), perfusion; single study at rest or stress Cardiac: PET 78492 Myocardial imaging, positron emission tomography (pet), perfusion; multiple studies at rest and/or stress MRI 76391 Magnetic resonance (eg, vibration) elastography Radiology: CT 70450 C T Head Without Contrast Radiology: CT 70460 C T Head With Contrast Radiology: CT 70470 C T Head Without & With Contrast Radiology: CT 70480 C T Orbit Without Contrast Radiology: CT 70481 C T Orbit With Contrast Radiology: CT 70482 C T Orbit Without & With Contrast Radiology: CT 70486 C T Maxillofacial Without Contrast Radiology: CT 70487 C T Maxillofacial With Contrast Radiology: CT 70488 C T Maxillofacial Without & With Contrast Radiology: CT 70490 C T Soft Tissue Neck Without Contrast Radiology: CT 70491 C T Soft Tissue Neck With Contrast Radiology: CT 70492 C T Soft Tissue Neck Without & With Contrast Radiology: CT 70496 C T Angiography Head Radiology: CT 70498 C T Angiography Neck Radiology: CT 71250 C T Thorax Without Contrast Radiology: CT 71260 C T Thorax With Contrast Radiology: CT 71270 C T Thorax Without & With Contrast Updated: 2/7/2019 V1.2019 Effective: 1/1/2019 Category CPT® Code CPT® Code Description C T Angiography Chest Without Contrast Material, Followed by Contrast Material and Further Sections,Including Image Radiology: CT 71275 Postprocessing Radiology: CT 72125 C T Cervical Spine Without Contrast Radiology: CT 72126 C T Cervical Spine With Contrast Radiology: CT 72127 C T Cervical Spine Without & With Contrast Radiology: CT 72128 C T Thoracic Spine Without Contrast Radiology: CT 72129 C T Thoracic Spine With Contrast Radiology: CT 72130 C T Thoracic Spine Without & With Contrast Radiology: CT 72131 C T Lumbar Spine Without Contrast Radiology: CT 72132 C T Lumbar Spine With Contrast Radiology: CT 72133 C T Lumbar Spine Without & With Contrast Radiology: CT 72191 C T Angiography Pelvis Radiology: CT 72192 C T Pelvis Without Contrast Radiology: CT 72193 C T Pelvis With Contrast Radiology: CT 72194 C T Pelvis Without & With Contrast Radiology: CT 73200 C T Upper Extremity Without Contrast Radiology: CT 73201 C T Upper Extremity With Contrast Radiology: CT 73202 C T Upper Extremity Without & With Contrast Radiology: CT 73206 C T Angiography Upper Extremity Radiology: CT 73700 C T Lower Extremity Without Contrast Radiology: CT 73701 C T Lower Extremity With Contrast Radiology: CT 73702 C T Lower Extremity Without & With Contrast Radiology: CT 73706 C T Angiography Lower Extremity Radiology: CT 74150 C T Abdomen Without Contrast Radiology: CT 74160 C T Abdomen With Contrast Radiology: CT 74170 C T Abdomen Without & With Contrast CT angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image Radiology: CT 74174 postprocessing Radiology: CT 74175 C T Angiography Abdomen Radiology: CT 74176 CT ABDOMEN AND PELVIS WITHOUT CONTRAST Radiology: CT 74177 CT ABDOMEN AND PELVIS WITH CONTRAST COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST MATERIAL IN ONE OR BOTH BODY Radiology: CT 74178 REGIONS, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS IN ONE OR BOTH BODY REGIONS Updated: 2/7/2019 V1.2019 Effective: 1/1/2019 Category CPT® Code CPT® Code Description Radiology: CT 74261 Computed tomographic (CT) colonography, diagnostic, including image postprocessing; without contrast material Computed tomographic (CT) colonography, diagnostic, including image postprocessing; with contrast material(s) including non- Radiology: CT 74262 contrast images, if performed Radiology: CT 74263 Computed tomographic (CT) colonography, screening, including image postprocessing Radiology: CT 75635 C T Angiography Abdominal Aorta Radiology: CT 76380 C T Limited Or Localized Follow-Up Study Radiology: CT 76497 Unlisted computed tomography procedure Radiology: CT 77078 Computed Tomography, bone mineral density study, 1 or more sites; axial skeleton Radiology: CT 0042T CT PERFUSION BRAIN Radiology: CT G0297 Low-dose Computed Tomography For Lung Cancer Screening SCINTIMAMMOGRAPHY (RADIOIMMUNOSCINTIGRAPHY OF THE BREAST), UNILATERAL, INCLUDING SUPPLY OF Radiology: CT S8080 RADIOPHARMACEUTICAL Radiology: CT S8092 ELECTRON BEAM COMPUTED TOMOGRAPHY (ALSO KNOWN AS ULTRAFAST CT, CINET) Radiology: MR 70336 M R I T M J Radiology: MR 70540 M R I Orbit, Face,Neck and/or Without Contrast Radiology: MR 70542 M R I Face, Orbit, Neck With Contrast Radiology: MR 70543 M R I Face, Orbit, Neck With & Without Contrast Radiology: MR 70544 M R A Head Without Contrast Radiology: MR 70545 M R A Head With Contrast Radiology: MR 70546 M R A Head With & Without Contrast Radiology: MR 70547 M R A Neck Without Contrast Radiology: MR 70548 M R A Neck With Contrast Radiology: MR 70549 M R A Neck With & Without Contrast Radiology: MR 70551 M R I Head Without Contrast Radiology: MR 70552 M R I Head With Contrast Radiology: MR 70553 M R I Head With & Without Contrast Radiology: MR 70554 MRI Brain, functional MRI Radiology: MR 70555 MRI Brain, functional MRI, requiring physician Radiology: MR 71550 M R I Chest Without Contrast Radiology: MR 71551 M R I Chest With Contrast Radiology: MR 71552 M R I Chest With
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